【摘要】： 目的：分析小切口大汗腺清除術(shù)治療腋臭的手術(shù)方法產(chǎn)生并發(fā)癥的原因和臨床表現(xiàn),探討預(yù)防措施及其并發(fā)癥的處理方法,以減少其不良并發(fā)癥,提高治療效果。 方法：對(duì)本科內(nèi)2007年4月～2010年4月期間226例行腋窩皮膚皺褶小切口大汗腺清除手術(shù)的腋臭患者術(shù)后出現(xiàn)的各種并發(fā)癥(包括血腫、皮下積液、血清腫、切口延遲愈合、表皮壞死、切口緣皮膚全層壞死、切口內(nèi)翻、假性皮脂腺囊腫、腋下皮膚不平整、上肢功能障礙、腋下瘢痕增生、腋區(qū)異味復(fù)發(fā))進(jìn)行分析和總結(jié),以采取有效的措施進(jìn)行預(yù)防和治療,提高手術(shù)效果。 結(jié)果：226例患者均采用腋窩皮膚皺褶小切口大汗腺清除術(shù),術(shù)后隨訪2個(gè)月至3年。190例患者切口一期愈合,異味消失。其余36例伴有并發(fā)癥,其中血腫11例,皮下積液3例,血清腫1例,切口延遲愈合5例,表皮壞死1例,切口緣皮膚全層壞死1例,切口內(nèi)翻2例,假性皮脂腺囊腫1例,腋下瘢痕增生5例,采取相應(yīng)的治療措施后,并發(fā)癥消失。腋下皮膚不平整3例,上肢功能障礙1例,未經(jīng)處理,3-6個(gè)月后自行恢復(fù)。復(fù)發(fā)2例,再次行手術(shù)治療后異味消失。 結(jié)論：目前常用的腋臭治療方法包括藥物外涂,藥物局部注射,激光治療以及手術(shù)治療。小切口大汗腺清除手術(shù)治療腋臭的手術(shù)方法清除汗腺比較徹底,切口隱蔽,復(fù)發(fā)率低,是目前最常用的手術(shù)方式,但是手術(shù)處理不當(dāng)會(huì)出現(xiàn)一些并發(fā)癥,影響了手術(shù)效果。通過(guò)完善的術(shù)前準(zhǔn)備,規(guī)范的手術(shù)操作及恰當(dāng)?shù)男g(shù)后處理,大部分并發(fā)癥是可以避免和控制的。
[Abstract]:Objective: to analyze the causes and clinical manifestations of complications in the treatment of axillary odor by small incision excision of sweat glands, and to explore the preventive measures and the management of complications in order to reduce the adverse complications and improve the therapeutic effect. Methods: all kinds of complications (including hematoma, subcutaneous effusion, serumatosis, incision delayed healing) occurred in 226 patients with axillary osmidrosis treated with axillary skin crease small incision during April 2007 to April 2010. Epidermal necrosis, full-thickness necrosis of incision margin, incision varus, pseudosebaceous gland cyst, axillary skin unevenness, upper limb dysfunction, axillary scar hyperplasia, axillary region odor recurrence) were analyzed and summarized. To take effective measures to prevent and treat, improve the results of surgery. Results: 226 patients were treated with axillary skin crinkle small incision big sweat gland clearance, followed up for 2 months to 3 years. 190 cases of incision healing, the smell disappeared. The other 36 cases had complications, including hematoma in 11 cases, subcutaneous effusion in 3 cases, serum swelling in 1 case, delayed healing in 5 cases, epidermal necrosis in 1 case, full-layer necrosis of incision edge in 1 case, incision varus in 2 cases, pseudosebaceous cyst in 1 case. There were 5 cases of axillary scar hyperplasia. The complications disappeared after the corresponding treatment. Axillary skin unevenness in 3 cases, upper limb dysfunction in 1 case, untreated, 3-6 months after self-recovery. Recurrence occurred in 2 cases, and the odour disappeared after reoperation. Conclusion: the commonly used methods of axillary osmidrosis treatment include drug application, drug injection, laser therapy and surgical treatment. The surgical method of removing sweat gland through small incision is more thorough, the incision is hidden and the recurrence rate is low, so it is the most commonly used operation method at present, but some complications will appear when the operation is improperly handled, which affects the effect of the operation. Most complications can be avoided and controlled by improved preoperative preparation, standardized operation and proper postoperative management.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2010
【分類(lèi)號(hào)】：R758.741

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